MEDICARE: ALICIA FLAMENCO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	810822	NV

General Provider Information

NPI Number	:	1023878287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA FLAMENCO

Provider Business Mailing Address
First Line	:	701 N GREEN VALLEY PKWY STE 286
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-6177
Country	:	US
Telephone Number	:	702-518-0008
Fax Number	:	702-729-0776

Provider Business Practice Location Address
First Line	:	701 N GREEN VALLEY PKWY STE 286
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-6177
Country	:	US
Telephone Number	:	702-518-0008
Fax Number	:	702-729-0776

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2024
Last Update Date	:	03/09/2026

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Directions to “ ALICIA FLAMENCO ” Practice Location

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